Early prostate cancer doesn’t usually have any symptoms. This makes understanding your risk and the value of screening, so important.
In essence, the prostate is a gland that lies just below the bladder. It secretes fluid, of which about 30% constitutes seminal fluid. This fluid helps not only to activate the sperm, but to maintain sperm mobility.
Prostate cancer is a malignancy of this gland and can develop when cells start to grow in an uncontrolled way. Sometimes this happens quickly and can spread to other parts of the body but usually this type of cancer develops slowly. This offers an opportunity to identify it in its early stages, with screening.
A PSA (prostate specific antigen) Screening is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood and the amount rises slightly as you get older. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.
What can affect your PSA level
Prostate problems, such as an enlarged prostate, prostatitis or prostate cancer can cause your PSA level to rise. Lots of other things can also affect your PSA level, for example:
- A urine infection –treatment will usually be given it If you have an infection. You’ll need to wait until your infection has cleared (around six weeks) before you have a PSA test.
- Vigorous exercise – You might be asked not to do any vigorous exercise in the 48 hours preceding your PSA test.
- Ejaculation – You may be asked to avoid any sexual activity that leads to ejaculation in the 48 hours before a PSA test.
- Anal sex and prostate stimulation – Receiving anal sex, or having your prostate stimulated during sex, might raise your PSA level for a while. It might be worth avoiding this for a week before a PSA test.
- Prostate biopsy – If you’ve had a biopsy in the six weeks before a PSA test, this could raise your PSA level.
- Medicines – Let your GP or practice nurse know if you’re taking any prescription or over-the-counter medicines, as some might affect your PSA level. For example, some medicines used to treat an enlarged prostate, known as 5-alpha-reductase inhibitors such as finasteride (Proscar®) or dutasteride (Avodart®), can reduce your PSA level and give a false test result.
- Other tests or surgery – If you’ve had any tests or surgery on your bladder or prostate, you may need to wait up to six weeks before having a PSA test.
- Urinary catheters – If you have a catheter to drain urine from your bladder, you may need to wait up to six weeks after it has been put in before having a PSA test.
Whilst things like ethnicity and family history can affect your risk of developing disease, deciding if a PSA test is right for you is a personal choice. To help in your decision, we have listed the pro’s and con’s of screening which we hope you find helpful:
Advantages of PSA Screening
- Screening can help to identify prostate cancer before you develop any symptoms.
- It can help detect fast-growing cancer at an early stage and enable early treatment.
- Regular PSA testing can be helpful in identifying any unusual increases in your PSA level, particularly if you are at an increased risk.
Disadvantages of PSA Screening
- Your PSA level might be raised, even if you don’t have prostate cancer which may affect your levels of anxiety.
- A PSA test can fail to detect prostate cancer.
- If it is discovered that your PSA level is raised, you may need a biopsy. This can cause side effects such as pain, infection and bleeding. It is more common that men now have an MRI scan first and a biopsy only if the scan finds anything unusual.
- Being diagnosed with a slow-growing prostate cancer that is unlikely to cause any problems or shorten your life can make you worry. It may also lead you to having treatments that you don’t need. Most men with low-risk, localised prostate cancer now have their cancer carefully monitored instead and only have treatment if the cancer starts to grow.
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